Over 14 million U.S. adults have chronic obstructive pulmonary disease, and many face barriers to using inhaled medications regularly and effectively. Although inhaled medications can improve daily life and long-term outcomes, only 25 to 43% of people with COPD use them regularly. In addition, inhalers can be complex to use--requiring users to master a series of six to eight steps that differ across devices. Physicians and health teams have not yet found a solution to bring COPD medication adherence to the level of other chronic diseases.
In a multi-site randomized controlled trial from the University of California, San Francisco, non-licensed, trained health coaches offered COPD patients one-on-one support in person and by phone, with contact at least every three weeks for nine months. Participants were primarily low-income, African American and Latino men in an urban area. Those who received health coaching showed significant improvement in adherence to controller inhalers and improved inhaler technique, with 40% of health-coached patients versus 11% of a control group able to demonstrate effective use of their inhalers after the intervention. Researchers conclude that "improved inhaler technique and adherence are one of multiple factors contributing to long-term COPD outcomes, but their research has confirmed one technique--use of lay health coaches--that may help patients get optimal benefit from their COPD medications.
Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial
Rachel Willard-Grace, MPH, et al
University of California, San Francisco, Department of Family and Community Medicine, San Francisco, California